Think Responsibly: A Closer Look at the Risks & Benefits of AlcoholJeff Novick, MS, RDN
Since alcohol is often promoted as healthy and even as a healthy beverage and has even made some of the lists of super foods...,
http://www.doctoroz.com/slideshow/dr-oz ... ue&page=11... let's take a closer look at the risks vs benefits of alcohol and put it all in perspective.
First, let’s clarify some definitions. While there is some variance in these definitions and recommendations around the world, most are in agreement with the following.
What Constitutes A Drink?A “drink” is considered to be:
- 1.5 oz of hard liquor
- 5 oz of wine
- 8-9 oz of malt beverage
- 12 oz of beer
Light Drinking:- averaging <1 drink/day and < 7 drinks/week
Moderate Drinking:- For Women:
- - <1 drink/day, < 7 drinks/week
— For Men:
- - < 2 drinks/day, < 14 drinks/week
with no more than 2 drinks on any given day for either men or women.
Heavy/Excessive Drinking:- For Women:
- - > 1 drink/day, > 8 drinks/week
- For Men:
- - > 2 drinks/day, > 15 drinks/week
Binge Drinking:> 4 drinks for women and > 5 drinks per men in a 2 hour period
Heavy, excessive and binge drinking are never recommended as excess alcohol consumption is the 3rd leading cause of lifestyle related deaths in the USA.
Proposed Benefits:- The main benefit we hear in regard to alcohol, and especially red wine, is that it can lower our risk for heart disease in several ways. Studies have shown that the moderate consumption of alcohol, and not just red wine, appears to lower the risk for heart disease. In addition, it also appears to lower the risk for diabetes, hypertension, stroke and dementia.
NOTE: Remember, most all of these proposed benefits come from observational studies, which, while of value, can never prove causation and at best, only a casual association. As we know with many other items (nuts, olive oil, etc) that have been discussed in detail here, these associations are often the result of a healthier lifestyle and not due to any one of these individual items in particular. Even the best observational studies, do not have that ability or power.
Potential Risks- The World Health Organization classifies alcohol as a Category 1 carcinogen. The reason is, the consumption of alcohol can raise your risk for cancer of the mouth, throat, esophagus, stomach, liver, colon and breast. It also increases the risk for liver disease, motor vehicle accidents, unintentional accidents, injuries, violence and drownings.
The question is, does the proposed benefit of moderate drinking outweigh the risk?
Risk vs Benefit- The greatest benefit is for older men and in regard to heart disease.
- The greatest risk is to women and in regard to breast cancer. Even light drinking, a level thought to have little risk, has been shown to raise a women’s risk for breast cancer. A recent review of over 100 studies found that light drinking was responsible for about 5,000 of the breast cancer deaths each year.
- Those who benefit the most are also those who live an unhealthy lifestyle.
If you do not smoke, are active (about 30 minutes most days) and ate just one serving of fruit or vegetables a day, there appears to be no benefit.***- We know that even without alcohol, a healthy lifestyle of 1) not smoking, 2) being at a healthy weight, 3) being active, and 4) eating a healthy diet can eliminate over 90% of heart disease, type 2 diabetes, hypertension and stroke and about 70% of cancers.
Does the risk outweigh the benefit?- This is really a question that can only be answered on a personal and individual case by case basis by someone in a conversation with their health care professional that takes into account their current lifestyle and all of the above information.
Considering that alcohol consumption is the 3rd leading cause of lifestyle related death in the USA, and that we can already eliminate most all of the risk for all of the conditions alcohol is supposed to help with, it is hard for me as health care professional to recommend any amount of alcohol as a preventative measure. So, I don’t and if you don’t drink, don’t start.
However, if you do drink, stay below the recommended amounts for light drinking and speak to your health care professional about your own personal risk/benefits.
Most importantly, remember, following a healthy lifestyle, even without any alcohol, gets you all the benefit without any of the risk.
In Health
Jeff
***Who benefits most from the cardioprotective properties of alcohol consumption--health freaks or couch potatoes? J Epidemiol Community Health. 2008 Oct;62(10):905-8. doi: 10.1136/jech.2007.072173.
Abstract
BACKGROUND:
The cardioprotective properties of moderate alcohol consumption, compared with abstinence or heavy drinking, are widely reported, but whether the benefits are experienced equally by all moderate drinkers is less well known.
AIMS:
To examine the association between average alcohol intake per week and the incidence of fatal and non-fatal myocardial infarction during 17 years of follow-up for 9655 men and women without prevalent disease in the general population; and to test whether the level of cardioprotection differs according to subjects' other health behaviours (healthy, moderately healthy, unhealthy) at entry to the study.
METHOD:
A longitudinal, British civil service-based cohort study, baseline in 1985-8.
RESULTS:
A significant benefit of moderate drinking compared with abstinence or heavy drinking was found among those with poor health behaviours (little exercise, poor diet and smokers). No additional benefit from alcohol was found among those with the healthiest behaviour profile (> or =3 hours of vigorous exercise per week, daily fruit or vegetable consumption and non-smokers).
CONCLUSION:
The cardioprotective benefit from moderate drinking does not apply equally to all drinkers, and this variability should be emphasised in public health messages.